不同分期慢性肾脏病患者BMD水平与IGF-1表达的相关性研究  

Study of the correlation between bone mineral density and the expression of IGF-1 in patients with chronic kidney diseases at different stages

作　　者：袁平[1] 龙艳君[2] 杨霞[2] 袁静[2] 程世平[2] 查艳[2] 

机构地区：[1]贵州省人民医院血管外科,贵阳550002 [2]贵州省人民医院肾脏泌尿疾病研究所,贵阳550002

出　　处：《中国骨质疏松杂志》2014年第1期26-28,共3页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金资助(81200539);国际合作项目(黔科合外G字[2012]7045号);省长基金(黔省专合字(2010)89号)

摘　　要：目的：研究不同分期慢性肾脏病患者血清胰岛素样生长因子-1（IGF-1）的表达与骨密度（BMD）的相关性。方法选取CKD2～5期患者各25例，应用DEXA骨密度仪测定1-4腰椎前后位BMD和T值，检测血清IGF-1水平及其他相关生化指标的表达。结果 CKD5期患者BMD和T值与体检人群有明显差异（P＜0.05），血清IGF-1值显著减少（P＜0.01），血清甲状旁腺激素（iPTH）及碱性磷酸酶（ALP）明显增高（P＜0.01），且血清IGF-1水平与BMD 呈正相关（r＝0.673）。结论 BMD测定敏感性较高，是目前早期诊断肾性骨病的较好方法；血清IGF-1值不仅可反应骨转换水平高低，而且与慢性肾脏病5期患者BMD的变化相平行，对CKD患者肾性骨病早期诊治和严重程度的判断中亦具有重要临床价值。Objective To investigate the correlation between bone mineral density （ BMD） and the expression of insulin-like growth factor-1（IGF-1） in patients with chronic kidney diseases （CKD） of the different stages.Methods Twenty-five patients with each stage of CKD （stage 2-5） were selected.BMD and the T value of the lumbar vertebrae （L1-L4） at the anteroposterior position were detected using DEXA.The serum levels of IGF-1 and other related biochemical indexes including intact parathyroid hormone （ iPTH） and alkaline phosphatase （ ALP） were also detected.Results BMD and the T values in patients with stage 5 CKD had significant difference to that in healthy controls （P＆lt;0.05）.The serum level of IGF-1 decreased significantly compared with that in healthy controls （P＆lt;0.01）, while the serum levels of iPTH and ALP increased significantly （P＆lt;0.05）.The serum level of IGF-1 was positively correlated with BMD in patients with stage 5 CKD.Conclusion The detection of BMD has high sensitivity, which is a good diagnostic method for the diagnosis of renal osteopathy at the early stage.The serum level of IGF-1 can reflect the level of bone turnover, and parallels with the changes of BMD in patients with stage 5 CKD, showing important clinical value in both the early diagnosis and treatment of renal osteopathy in patients with CKD and the evaluation of the severity of the diseases.

关 键 词：慢性肾脏病 骨密度 IGF-1 

分 类 号：R5[医药卫生—内科学]